Clinical Guidelines for Low Back Pain Call for Conservative Approach First

Monday, May 23, 2011

Clinical Guidelines for Low Back Pain Call for Conservative Approach First

Updated clinical guidelines developed for patients age 18 and older with symptoms of low back pain or radiculopathy aim to increase conservative approaches, such as physical activity, as first-line treatment for this population.

The recommendations call for subjective pain rating; functional status; patient history, including notation of presence or absence of "red flags" and psychosocial indicators; assessment of prior treatment and response; employment status; and clinician's objective assessment. The guidelines also propose reducing unnecessary imaging unless "red flag" indicators exist, placing an emphasis on patient education and conservative home self-care, and returning "early" to work or activities. Additionally, they report that there is evidence that exercise therapy is effective for chronic back pain.

Evidence supporting the recommendations, the benefits/harms of implementing the guideline recommendations, and information about the guideline developers also is available.

Read the guidance from the Institute for Clinical Systems Improvement at the Agency for Healthcare Research and Quality's National Guideline Clearinghouse.

Comments

Why are physical therapists not included in the list of intended users?

Posted by Cory Manton
on 5/27/2011 2:22 PM

I agree that exercise is one of the "first responses" but also know from being a therapist and treating many backs, that exercises are far too often performed incorrectly when they are the appropriate ones, but also far too ften not the correct ex for the condition, but the patient is "persistent", causing more harm than help. PT's are recommended to guide in choosing the CORRECT ex and te4chnique.

Posted by Sue Baker
on 5/30/2011 11:41 AM

Hi, just checking this now but the guidelines either do list or it was updated for PTs under the intended user section. And, I guess we'd be included under PM&R for clinical specialty.
I looked at ICSI's staff and luckily there is 1 PT listed, but only 1. :( shown here:
http://www.icsi.org/about/icsi_staff/